强化透析联合强化容量控制对血液透析患者血压的影响  

Influence of Different Dialysis Doses and Volume Control on Blood Pressure of Maintenance Hemodialysis Patients

作　　者：张文君[1] 王俭勤[1] 王文革[1] 常守凤[1] 崔永宏[1] 冯玲[1] 张莉[1] 

机构地区：[1]兰州大学第二医院肾内科,甘肃省兰州市730030

出　　处：《中国全科医学》2010年第18期1958-1961,共4页Chinese General Practice

摘　　要：目的探讨强化透析联合强化容量控制对血液透析患者血压的影响。方法将入选的120例血液透析患者随机分为4组:常规容量控制+常规透析组(CRCJ组)、常规容量控制+强化透析组(CRQJ组)、强化容量控制+常规透析组(QRCJ组)、强化容量控制+强化透析组(QRQJ组)。观察研究前、研究的第6、12个月各组患者的收缩压及舒张压,研究期间透析相关性高血压、低血压的发生率及患者所服降压药物的种类和费用,患者的干体质量,体质量变化,超滤量,超滤速度及尿素氮清除率(Kt/V)。结果 (1)研究前4组患者的血压水平间差异无统计学意义(P>0.05),研究的第6个月,强化容量控制+强化透析组患者的血压与研究前相比明显降低(P<0.05),而其他3组患者的血压无明显下降。研究的第12个月,各组患者的血压与研究前相比均明显降低(P<0.05),但强化容量控制+强化透析组较其他3组下降显著(P<0.05)。(2)强化容量控制+强化透析组透析相关高血压发生率明显低于其他3组(P<0.05),透析相关低血压发生率明显低于常规容量控制+强化透析组、常规容量控制+常规透析组(P<0.05),但与强化容量控制+常规透析组比较差异无统计学意义(P>0.05)。(3)强化容量控制+强化透析组患者1年内服降压药物的种类及费用明显低于其他3组(P<0.05)。结论强化容量控制联合强化透析可以降低维持性血液透析患者的血压、透析相关性高血压和低血压的发生率,减少透析患者服降压药物的费用。Objective To explore the influence of different dialysis doses and volume control on blood pressure of the maintenance hemodialysis（MH） patients in Gansu province.Methods One hundred and twenty MH patients were randomly assigned into 4 groups：conventional dialysis and conventional volume control group（CJCR,n=30）,conventional dialysis and strengthened volume control group（CJQR,n=30）,strengthened dialysis and conventional volume control group（QJCR,n=30）,strengthened dialysis and strengthened volume control group（QJQR,n=30）.The main observation indicators included blood pressure（BP）,dialysis-related hypotension and hypertension,the number and cost of antihypertensive medications in a year and so on.Results There was no significant difference in blood pressure（BP） between 4 groups before treatment（P0.05）.In 6 months of treatment,BP of QJQR group decreased remarkably as compared with pre-treatment（P0.05）,but that of the other 3 groups did not.In months 12,BP decreased significantly in all groups（P0.05）,but QRQJ group decreased more（P0.05）.The incidence of dialysis-related hypertension was significantly higher in QRQJ group than in other 3（P0.05）,that of dialysis-related hypotension lower than in CRQJ,CRCJ groups（P0.05）,but there was not significant difference between groups QRQJ and QRCJ（P0.05）.The number and cost of antihypertensive drugs that patients took in 1 year were significantly lower in QRQJ group than in other 3（P0.05）.Conclusion Strengthened volume control with enhanced dialysis can reduce the BP and the incidence of dialysis-related hypertension and hypotension,decrease the cost of antihypertensive drugs in MH patients.

关 键 词：血液透析 容量控制 透析剂量 血压 

分 类 号：R692[医药卫生—泌尿科学]